Disparities in the uptake of HPV-related cancer prevention strategies among women by HIV status in Puerto Rico

Abstract

Background

Women living with HIV (WLWH) are at increased risk of persistent HPV infection and HPV-related cancers than persons without HIV. We aimed to describe the utilization of primary and secondary prevention strategies for HPV-related cancers among women by HIV status in Puerto Rico (PR).

Methods

We performed a secondary data analysis of women aged 21+ years (n = 469) evaluated at the Anal Neoplasia Clinic (ANC) of the University of Puerto Rico Comprehensive Cancer Center between 2014 and 2023. The outcomes were history of HPV vaccination, anal Pap screening, and cervical Pap screening in the past 3 years. Descriptive statistics were employed to characterize the study population and comparisons were made by HIV status.

Results

Women’s mean age in our study was 50.2 ± 12.1 years; 75.7 % were living with HIV. Among women who were age-eligible for HPV vaccination, 21.7 % reported receiving the HPV vaccine; WLWH were less likely vaccinated than women without HIV (14.7 % vs. 38.7 %, p < 0.01). Prevalence of cervical and anal Pap screening were significantly higher among WLWH (98.6 % and 89.9 %, respectively) than in women without HIV (94.4 % and 47.7 %, respectively). Several risk factors for HPV-related disease were more common among WLWH, such as age at first sexual encounter (≤ 16 years) (54.7 %), more than six lifetime sexual partners (43.1 %), and being a current smoker (23.6 %).

Conclusions

Although we observed high uptake of cervical and anal Pap screening in this clinic-based sample, HPV vaccination was deficient. Future studies should involve developing tailored cancer prevention strategies for WLWH to increase HPV vaccination uptake.